The Effect of Scaphoid and Hamate Mobilization on Treatment of Patients with Carpal Tunnel Syndrome

Vida Dinarvand, Iraj Abdollahi, Seyed Ahmad Raeissadat, Mohammad Ali Mohseni Bandpei, Marzieh Babaee, Ailin Talimkhani, Vida Dinarvand, Iraj Abdollahi, Seyed Ahmad Raeissadat, Mohammad Ali Mohseni Bandpei, Marzieh Babaee, Ailin Talimkhani

Abstract

Background: This study was to evaluate the effect of hamate and scaphoid bone mobilization alongside splinting in women with carpal tunnel syndrome.

Methods: In this randomized clinical trial, 40 participants were randomly assigned into 2 groups. The intervention group received splinting with scaphoid and hamate mobilization, while the control group received splinting only. Outcome variables were pain (based on visual analogue scale), symptom severity and functional status (based on Boston questionnaire), and nerve conduction study measured before and 10 weeks after the treatments.

Results: At the end of study, both groups showed an improvement in pain and symptom severity, functional status as well as median nerve conduction study. Although there was no statistically significant difference between groups regarding changes in median nerve sensory and motor distal latencies; the improvement was significantly higher in pain and symptom severity as well as functional status in mobilization group (P-Value < 0.05).

Conclusions: Hamate and scaphoid mobilization can be used as an effective option in women with mild to moderate carpal tunnel syndrome. Further investigation is required for determining long-term effects and cost-effectiveness of mobilization in carpal tunnel syndrome.

Keywords: Carpal Tunnel Syndrome; Mobilization; Scaphoid and Hamate; Splint.

Figures

Figure 1.. CONSORT Flow Diagram
Figure 1.. CONSORT Flow Diagram

References

    1. Chammas M, Boretto J, Burmann LM, Ramos RM, Dos Santos Neto FC, Silva JB. Carpal tunnel syndrome - Part I (anatomy, physiology, etiology and diagnosis). Rev Bras Ortop. 2014;49(5):429–36. doi: 10.1016/j.rboe.2014.08.001.
    1. Ibrahim I, Khan WS, Goddard N, Smitham P. Carpal tunnel syndrome: a review of the recent literature. Open Orthop J. 2012;6:69–76. doi: 10.2174/1874325001206010069.
    1. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999;282(2):153–8. doi: 10.1001/jama.282.2.153.
    1. Katz JN, Larson MG, Sabra A, Krarup C, Stirrat CR, Sethi R, et al. The carpal tunnel syndrome: diagnostic utility of the history and physical examination findings. Ann Intern Med. 1990;112(5):321–7. doi: 10.7326/0003-4819-112-5-321.
    1. Rozali ZI, Noorman FM, De Cruz PK, Feng YK, Razab HW, Sapuan J, et al. Impact of carpal tunnel syndrome on the expectant woman's life. Asia Pac Fam Med. 2012;11(1):1. doi: 10.1186/1447-056X-11-1.
    1. Raeissadat SA, Rayegani SM, Rezaei S, Sedighipour L, Bahrami MH, Eliaspour D, et al. The effect of polarized polychromatic noncoherent light (bioptron) therapy on patients with carpal tunnel syndrome. J Lasers Med Sci. 2014;5(1):39–46.
    1. Rayegani SM, Bahrami MH, Eliaspour D, Raeissadat SA, Shafi Tabar Samakoosh M, Sedihgipour L, et al. The effects of low intensity laser on clinical and electrophysiological parameters of carpal tunnel syndrome. J Lasers Med Sci. 2013;4(4):182–9.
    1. Kumnerddee W, Kaewtong A. Efficacy of acupuncture versus night splinting for carpal tunnel syndrome: a randomized clinical trial. J Med Assoc Thai. 2010;93(12):1463–9.
    1. Wu YT, Ke MJ, Chou YC, Chang CY, Lin CY, Li TY, et al. Effect of radial shock wave therapy for carpal tunnel syndrome: A prospective randomized, double-blind, placebo-controlled trial. J Orthop Res. 2016;34(6):977–84. doi: 10.1002/jor.23113.
    1. Incebiyik S, Boyaci A, Tutoglu A. Short-term effectiveness of short-wave diathermy treatment on pain, clinical symptoms, and hand function in patients with mild or moderate idiopathic carpal tunnel syndrome. J Back Musculoskelet Rehabil. 2015;28(2):221–8. doi: 10.3233/BMR-140507.
    1. Ashraf A, Moghtaderi AR, Yazdani AH, Mirshams S. Evaluation of effectiveness of local insulin injection in non-insulin-dependent diabetic patient with carpal tunnel syndrome. Electromyogr Clin Neurophysiol. 2009;49(4):161–6.
    1. Bahrami MH, Shahraeeni S, Raeissadat SA. Comparison between the effects of progesterone versus corticosteroid local injections in mild and moderate carpal tunnel syndrome: a randomized clinical trial. BMC Musculoskelet Disord. 2015;16:322. doi: 10.1186/s12891-015-0752-6.
    1. Raeissadat SA, Shahraeeni S, Sedighipour L, Vahdatpour B. Randomized controlled trial of local progesterone vs corticosteroid injection for carpal tunnel syndrome. Acta Neurol Scand. 2017;136(4):365–71. doi: 10.1111/ane.12739.
    1. Edmond SL. Manipulation and mobilization: extremity and spinal techniques. Mosby; 1993.
    1. Gunay B, Alp A. The effectiveness of carpal bone mobilization accompanied by night splinting in idiopathic carpal tunnel syndrome. Turk J Phys Med Rehab. 2015;61(1):45–50. doi: 10.5152/tftrd.2015.70446.
    1. De-la-Llave-Rincon AI, Ortega-Santiago R, Ambite-Quesada S, Gil-Crujera A, Puentedura EJ, Valenza MC, et al. Response of pain intensity to soft tissue mobilization and neurodynamic technique: a series of 18 patients with chronic carpal tunnel syndrome. J Manipulative Physiol Ther. 2012;35(6):420–7. doi: 10.1016/j.jmpt.2012.06.002.
    1. Butler DS, Jones MA, Gore R. Mobilisation of the nervous system. Australia: Churchill Livingstone Melbourne; 1991.
    1. Tal-Akabi A, Rushton A. An investigation to compare the effectiveness of carpal bone mobilisation and neurodynamic mobilisation as methods of treatment for carpal tunnel syndrome. Man Ther. 2000;5(4):214–22. doi: 10.1054/math.2000.0355.
    1. Chen LC, Ho CW, Sun CH, Lee JT, Li TY, Shih FM, et al. Ultrasound-Guided Pulsed Radiofrequency for Carpal Tunnel Syndrome: A Single-Blinded Randomized Controlled Study. PLoS One. 2015;10(6):e0129918. doi: 10.1371/journal.pone.0129918.
    1. Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am. 1993;75(11):1585–92.
    1. Rezazadeh A, Bakhtiary AH, Samaei A, Moghimi J. Validity and reliability of the Persian Boston questionnaire in Iranian patients with carpal tunnel syndrome [In Persian]. Koomesh . 2014;15(2):138–45.
    1. Lue YJ, Wu YY, Liu YF, Lin GT, Lu YM. Confirmatory Factor Analysis of the Boston Carpal Tunnel Questionnaire. J Occup Rehabil. 2015;25(4):717–24. doi: 10.1007/s10926-015-9579-0.
    1. Werner RA, Andary M. Electrodiagnostic evaluation of carpal tunnel syndrome. Muscle Nerve. 2011;44(4):597–607. doi: 10.1002/mus.22208.
    1. Sitruk-Ware R, El-Etr M. Progesterone and related progestins: potential new health benefits. Climacteric. 2013;16 Suppl 1:69–78. doi: 10.3109/13697137.2013.802556.
    1. Heebner ML, Roddey TS. The effects of neural mobilization in addition to standard care in persons with carpal tunnel syndrome from a community hospital. J Hand Ther. 2008;21(3):229–40. doi: 10.1197/j.jht.2007.12.001. quiz 241.
    1. Brininger TL, Rogers JC, Holm MB, Baker NA, Li ZM, Goitz RJ. Efficacy of a fabricated customized splint and tendon and nerve gliding exercises for the treatment of carpal tunnel syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2007;88(11):1429–35. doi: 10.1016/j.apmr.2007.07.019.
    1. Burke J, Buchberger DJ, Carey-Loghmani MT, Dougherty PE, Greco DS, Dishman JD. A pilot study comparing two manual therapy interventions for carpal tunnel syndrome. J Manipulative Physiol Ther. 2007;30(1):50–61. doi: 10.1016/j.jmpt.2006.11.014.
    1. Pratelli E, Pintucci M, Cultrera P, Baldini E, Stecco A, Petrocelli A, et al. Conservative treatment of carpal tunnel syndrome: comparison between laser therapy and Fascial Manipulation((R)). J Bodyw Mov Ther. 2015;19(1):113–8. doi: 10.1016/j.jbmt.2014.08.002.
    1. George JW, Tepe R, Busold D, Keuss S, Prather H, Skaggs CD. The effects of active release technique on carpal tunnel patients: A pilot study. J Chiropr Med. 2006;5(4):119–22. doi: 10.1016/S0899-3467(07)60143-8.
    1. Elliott R, Burkett B. Massage therapy as an effective treatment for carpal tunnel syndrome. J Bodyw Mov Ther. 2013;17(3):332–8. doi: 10.1016/j.jbmt.2012.12.003.
    1. Raeissadat A, Soltani ZR. Study of long term effect of laser therapy versus local corticosteroid injection in patients with carpal tunnel syndrome. [in Persian] J ‎Laser Med. Sci. 2010;1(1):24.
    1. Rayegani SM, Kargozar E, Eliaspour D, Raeissadat S.A, Sanati E, Bayat M. Diagnostic value of ultrasound compared to electro diagnosis in carpal tunnel syndrome. Patient Saf Qual Improv. 2014;2(4):142–7.
    1. Rayegani SM, Sedighipour L, Raeissadat SA, Hojjati F, Aghayousefi HR, Lahiji F, Sanei Taheri M. Co-occurrence of trifid and bifid median nerves in a patient with bilateral carpal tunnel syndrome. Neurol India. 2015 Sep-Oct;63(5):778–9. doi: 10.4103/0028-3886.166535.

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